Blood pressure

Blood pressure is a biological variable that varies with time. A series of factors linked to daily activities and independent neurohormonal mechanisms cause blood pressure to vary significantly within the 24 hours of the day: it increases during physical activity and decreases considerably following acute exercise (post-exercise hypotension); it increases in conditions of physical or emotional distress and tends to decrease after meals and during sleep.1 Blood pressure variation throughout the sleep-wake cycle is well known, with lower values observed during night time sleep than in daytime wakefulness. The advent of non-invasive methods to measure blood pressure for 24 hours such as ambulatory blood pressure monitoring (ABPM) shed more light onto the behaviour of blood pressure. Changes in blood pressure during sleep have also been associated with increased risk of cardiovascular and renal disease in the long term: it is the classical description of inadequate or absent drops in blood pressure during sleep seen in attenuated dippers and non-dippers, respectively, associated with left ventricular hypertrophy, hypertensive retinopathy, and proteinuria.2 A mathematical formula based on the different blood pressure levels observed in subperiods of the sleep-wake cycle was recently proposed to estimate the early morning rise in blood pressure. Pronounced rises in blood pressure during this time of the day (“early morning surge”) have also been used to independently predict mean 24-hour, wake, and sleep blood pressure and the Blood pressure variability3

Nurses are involved in the prevention and management of chronic diseases like hypertension in primary health care settings. However, information about the roles of nurses in prevention and managing high blood pressure in South-South Nigeria remains scarce. Therefore, this research attempts to relate the performance of nurses roles in preventing high blood pressure with their qualifications in primary health care centres in Delta State. Interviewer’s administered questionnaire was used to gather information from eighty-five nurses chosen from the twenty-nine randomly selected primary health care centres in the twenty five local government areas of Delta State. Results show that the nurses performed the roles at varying degrees judged to be poor overall. The nurses’ identified roles and level of performance bear no significant relationship to their qualifications. It was also observed that most of the nurses had no training in the management of hypertension and do not use the recommended NHA guidelines. These indicate the need for facilitators to organize training courses on hypertension management for nurses, and integrate such into the curriculum for nursing education.